Faizi Zaheer, Kim Daniel W, Humayun Ammar, Batool Amber, Ratnasekera Ashanthi
General Surgery, Crozer-Chester Medical Center, Upland, USA.
Surgery, Crozer-Chester Medical Center, Upland, USA.
Cureus. 2022 Mar 22;14(3):e23384. doi: 10.7759/cureus.23384. eCollection 2022 Mar.
In the wake of the novel coronavirus disease 2019 (COVID-19) pandemic and its associated mortality and virulence, a high clinical suspicion must be maintained for all patients presenting with respiratory failure. However, there are well-known disease processes that may have a similar presentation. We present a case of a 25-year-old male who suffered a right tibia fracture after a motor vehicle collision. He had acute hypoxic respiratory failure within 24 hours of admission, requiring mechanical ventilation. His condition significantly improved with airway pressure release mode of ventilation and proning. Although his chest CT demonstrated characteristic findings of COVID-19, he subsequently tested negative. The differential included aspiration pneumonia and fat embolism syndrome from the lower extremity fracture. Fat embolism syndrome can very closely mimic COVID-19. The rapid onset and improvement of symptoms coupled with serial negative COVID-19 testing may aid in the diagnosis.
在2019年新型冠状病毒病（COVID-19）大流行及其相关的死亡率和毒力之后，对于所有出现呼吸衰竭的患者，必须保持高度的临床怀疑。然而，存在一些众所周知的疾病过程可能有类似的表现。我们报告一例25岁男性，在机动车碰撞后发生右胫骨骨折。他在入院后24小时内出现急性低氧性呼吸衰竭，需要机械通气。采用气道压力释放通气模式和俯卧位后，他的病情显著改善。尽管他的胸部CT显示有COVID-19的特征性表现，但随后检测结果为阴性。鉴别诊断包括吸入性肺炎和下肢骨折引起的脂肪栓塞综合征。脂肪栓塞综合征可能与COVID-19非常相似。症状的快速出现和改善以及连续的COVID-19检测阴性可能有助于诊断。
